Citation Nr: 0718599
Decision Date: 06/21/07 Archive Date: 07/03/07
DOCKET NO. 05-30 102 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Nashville,
Tennessee
THE ISSUES
1. Entitlement to service connection for post-traumatic
stress disorder (PTSD).
2. Entitlement to service connection for hypertension with
headaches, to include on a secondary basis.
3. Entitlement to service connection for tinnitus, to
include on a secondary basis.
REPRESENTATION
Appellant represented by: Vietnam Veterans of America
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
F. Fuller, Associate Counsel
INTRODUCTION
The veteran served on active duty from September 1965 to
August 1975. This case comes before the Board of Veterans'
Appeals (Board) on appeal of an August 2003 rating decision
of the Department of Veterans Affairs (VA) Regional Office
(RO) in Nashville, Tennessee.
REMAND
Service connection for PTSD requires: (1) medical evidence
diagnosing the condition in accordance with 38 C.F.R. §
4.125(a) (i.e., DSM-IV); (2) a link, established by medical
evidence, between current PTSD symptoms and an in-service
stressor; and (3) credible supporting evidence that the
claimed in-service stressor occurred. See 38 C.F.R. §
3.304(f) (2006).
The medical evidence shows that the veteran has been
diagnosed with PTSD, but the evidence currently of record
does not establish his participation in combat with the enemy
or corroborate the occurrence of a stressor supporting the
diagnosis of PTSD.
Although some of the veteran's alleged stressors are not
verifiable or do not appear to have contributed to his
development of PTSD, at his November 2005 Travel Board
Hearing, he testified that while assigned to the 616th
Maintenance Group at Tan Son Nhut Air Base from August 1968
to September 1969, his unit was subjected to frequent rocket
attacks. The veteran also claimed that the he was
approximately 300 yards from the closest attack and that a
clerk was wounded or killed in one such rocket attack. These
attacks are potentially verifiable but the RO has not
undertaken any development to do so.
The veteran also contends that he has hypertension with
headaches, secondary to his service-connected diabetes
mellitus. In the Board's opinion, he should be afforded a VA
examination to determine the etiology of his hypertension.
The veteran also contends that he has developed tinnitus as a
result of medication (Prozac) taken for PTSD and depression.
The veteran also contends that he has constant ringing in his
ears which he believes is a result of noise exposure in
service. Specifically, during his November 2005 hearing, the
veteran testified that while serving as an aircraft
maintenance specialist in service, he was exposed to noise
from jet aircraft engines. Although outpatient treatment
records from the VA Medical Center in Memphis, Tennessee do
not show complaints of tinnitus from the veteran until 2002,
his Form DD-214 does show that he served as an aircraft
maintenance specialist in service. Therefore, the Board
finds that in light of the veteran's contentions and the
circumstances of his service, he should be afforded a VA
examination to determine the etiology of any currently
present tinnitus.
In addition, while the case is in remand status, the veteran
should be provided notice in compliance with Dingess/Hartman
v. Nicholson, 19 Vet. App. 473 (2006).
Accordingly, the case is REMANDED to the RO or the Appeals
Management Center (AMC), in Washington, DC for the following
actions:
1. In response to all three of his
claims, the veteran should be provided the
notice required under 38 U.S.C.A. §
5103(a) (West 2002) and 38 C.F.R. §
3.159(b) (2006), to include the notice
specified by the Court in Dingess/Hartman
and notice that he should submit any
pertinent evidence in his possession.
2. The RO or the AMC should undertake
appropriate development to obtain any
pertinent evidence identified but not
provided by the veteran. If it is unable
to obtain any such evidence, it should so
inform the veteran and his representative
and request them to submit the outstanding
evidence.
3. Then, the RO or the AMC should contact
the U.S. Army and Joint Services Records
Research Center (JSRRC), formerly known as
the U.S. Armed Forces Service Center for
Unit Records Research (CURR) and request it
to verify the veteran's allegation that his
unit was subjected to rocket attacks by the
enemy.
4. If, and only if, an in-service stressor
event is verified by the JSRRC, the veteran
should be scheduled for a VA psychiatric
examination to determine whether he has
PTSD (under DSM-IV criteria) related to the
verified event(s) in service. The
veteran's claims folder must be made
available to and reviewed by the examiner.
If PTSD is diagnosed, the examiner should
identify the elements supporting the
diagnosis. If PTSD is not diagnosed, the
examiner should explain why the veteran
does not meet the criteria for this
diagnosis.
5. The RO or the AMC should arrange for
the veteran to undergo a VA examination by
a physician with appropriate expertise to
determine the etiology of his hypertension
with headaches. The claims folder must be
made available to and reviewed by the
examiner. Any indicated studies should be
performed. The examiner should provide an
opinion as to whether there is a 50 percent
or better probability that the veteran's
hypertension is etiologically related to
his active service or was caused or
chronically worsened by service-connected
disability. The rationale for all opinions
expressed must also be provided.
6. The veteran should also be afforded a
VA examination to determine the nature and
etiology of any currently present tinnitus.
The claims folders must be made available
to and reviewed by the examiner. Any
indicated studies should be performed.
A diagnosis of tinnitus should be
confirmed or ruled out. If tinnitus
is diagnosed, the examiner should
provide an opinion as to whether
there is a 50 percent or better
probability that the disorder is
etiologically related to noise
exposure in service.
The examiner should also provide an
opinion as to whether there is a 50
percent or better probability that
the veteran's tinnitus was caused or
chronically worsened by medication
taken for PTSD and depression.
The rationale for all opinions
expressed must also be provided.
7. After completion of the above and any
other development it determines to be
warranted, the RO or the AMC should
readjudicate the issues on appeal on a de
novo basis. If any of the benefits sought
on appeal are not granted to the veteran's
satisfaction, the veteran and his
representative should be issued an
appropriate supplemental statement of the
case and afforded the requisite opportunity
to respond. The case should then be
returned to the Board for further appellate
action, if otherwise in order.
By this remand, the Board intimates no opinion as to any
final outcome of this case. The veteran need take no action
until he is otherwise notified.
The appellant has the right to submit additional evidence and
argument on the matters the Board has remanded. See
Kutscherousky v. West, 12 Vet. App. 369 (1999).
This claim must be afforded expeditious treatment. The law
requires that all claims that are remanded by the Board of
Veterans' Appeals or by the United States Court of Appeals
for Veterans Claims for additional development or other
appropriate action must be handled in an expeditious manner.
See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2006).
_________________________________________________
Shane A. Durkin
Veterans Law Judge, Board of Veterans' Appeals
Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Appeals for Veterans Claims. This remand is in the
nature of a preliminary order and does not constitute a
decision of the Board on the merits of your appeal.
38 C.F.R. § 20.1100(b) (2006).